Understanding Traumatic Brain Injury - YouTube

Understanding Traumatic Brain Injury - YouTube: "http://youtu.be/9Wl4-nNOGJ0" 'via Blog this'

How I'm doing today

It was my hope that the results of two recent sleep studies, and the introduction of a better Bi-PAP machine to help me breathe at night would bring about some improvement in my various symptoms. I have seen some changes which might be positive for the long-term, but I'm not seeing any changes that could be defined as improvements.

The remaining symptoms which seem to take turns playing the role of "greatest annoyance" are: excessive sleep, on-going event amnesia, generalized pain (the intensity varies a lot, but it is always limiting my activities), and difficulty focusing (which also varies a lot).

Quality of Sleep
The most positive change after the introduction of the bi-pap machine has been the quality of sleep. I don't really notice that change, because I'm asleep, but my new bi-pap machine records lots of data, and shows a marked improvement since I began using the machine. I also have monitored my sleep using a cell phone app that records sounds I make as I sleep, and graphs my periods of stillness and motion. That data agrees that my sleep quality is improved.

From my perspective, my nights used to pass dreamlessly, in the blink of an eye. Now I notice long periods of time during which I obviously drift asleep and regain conciousness again, but the biggest change is that I dream (or remember dreaming). Sometimes I wake up with inspiration about some problem I've been working on, as I used to experience before my accident.

I'm not despairing of improvement from improved sleep, but it's not happening fast enough to seem like a real solution to my difficulties.

Excessive Daytime Sleep
The patterns that shape my awareness of narcolepsy have changed. I used to feel sleepy all the time, and would go through long periods in which I was repeating actions in a vicious cycle: starting to do something, getting distracted, forgetting what I was doing, feeling disoriented, finding something I needed to do, and starting to do it (repeat). That still happens when I am tired, but not as often, and not as long when it happens. Now I actually feel refreshed after a period of sleep, although that feeling does not last. When I begin to loose steam, I am aware enough of what is happening that I can take steps to prevent extreme confusion. I have greatly increased my use of caffeine, which can help prolong my useful periods of wakefulness, and I have better judgment about when to stop and take a nap.

Hallucinations
A common symptom of narcolepsy is daytime dreaming, or hallucinations. I am a bit surprised at myself for how undisturbed I was about seeing things that weren't there. My psychiatrist was obviously more concerned than me. He had me taking an antipsychotic drug that did stop the hallucinations. I did not mind the hallucinations. I was more impressed that the drug (Abilify) helped me to focus, so I liked taking the drug, but it also caused weight gain that eventually began causing more trouble than it was solving. I stopped taking the drug because of the weight gain. (I have not lost all of that extra weight yet, but it's coming off gradually.) When I stopped taking the drug, I expected the hallucinations to return, but they never returned, and now that I am dreaming at night, I don't think daytime dreaming is likely to happen now.

Amnesia
Amnesia can be difficult to report, because I tend to forget those incidents when I notice it. It imposes itself most noticeably when it affects my sense of reality. For example, this morning, as I was creating the graphic for this post, my daughter walked through the room. I distinctly remembered driving her to work, and it was a shock to me to see her here. Obviously I was recalling an earlier time when I took her to work. Another example of on-going amnesia is that I have started watching a television series that I had given up on previously, because I had seen all of the episodes. I still remember that I liked the series, and I still associate the actors with the show when I see them in other contexts, but so far, not one episode that I have watched recently seemed even slightly familiar. They are all completely new to me. A long time ago I developed a routine of keeping a journal to accommodate my lost event memory. I use Evernote to record my journal information because Evernote indexes that information for me so I can look up notes quickly.

Generalized Pain
I recently added Advil to my morning meds, and Tylenol to my evening meds. Advil has made a significant difference in my quality of life, but it does not allow me to be as active as I need to be. I'm going to focus on loosing weight as my primary strategy to reduce pain, but if that does not work, my next plan is to look into joint replacement surgery.... I am also trying to change my perspective on pain by not allowing myself to focus on it, or any of my other complaints, but instead to focus on what is good in every situation.

Difficulty Focusing
My difficulty with focusing has recently been my most disabling symptom. It is strongly associated with my on-going difficulty with amnesia. It is difficult to focus when you keep forgetting what you were thinking about.... Drugs help to some extent, mainly by enabling me to do more between memory lapses. Keeping notes in front of me at all times helps me to return my attention to the current task when I become distracted.

Conclusion
I'm getting tired again. Soon it will be time for another nap. Below, I (will) have copied some things I recently posted on Facebook that provide a window to see how I deal with various difficulties day by day. I hope this post is helpful to others.

As always, please comment. I especially appreciate suggestions about resources I have not yet discovered.

(part one)

(part two)

 

Here's a fun fact to know and tell: Brain injury can make you smarter

Jim Varney
(aka Ernest P. Worrell)

Here's a fun fact to know and tell: brain injury can make you smarter, however unlikely that may be.

Reverberi, C., Toraldo, A., D’Agostini, S., & Skrap, M. (2005). Better without (lateral) frontal cortex? Insight problems solved by frontal patients. Brain, 128(12), 2882–2890. https://doi.org/10.1093/brain/awh577

'via Blog this'

Excerpts from the article: The Helmet Wars.

(Foster, T., 2013)

Two helmets in one, an inner shell snug against the head, with an outer shell resembling a traditional helmet, separated by a slippery cushion that allows the outer helmet to rotate independently of the inner helmet, can reduce rotational energy by 55 percent (Foster, T., 2013), making the difference of whether an impact to the head causes concussion. No helmets currently in use can prevent rotation, the primary cause of concussion. Current helmet tests do not attempt to measure rotation, making them useless for predicting their ability to protect against concussion.

For generations, doctors believed that concussions were a sort of bruising of the brain's gray matter at the site of impact and on the opposite side, where the brain presumably bounced off the skull. The reality is not nearly that simple: Concussions happen deep in the brain's white matter when forces transmitted from a big blow strain nerve cells and their connections, the axons. (Foster, T., 2013) 

"Rotational forces strain nerve cells and axons more than linear forces do," Cantu says. "They're not only stretching, but they're twisting at the same time. So they have a potential for causing greater nerve injury." (Foster, T., 2013)

First up in Halldin's test is the non-MIPS helmet. Halldin flips on a high-speed camera and steps back from the impactor, ready to catch the helmet on its rebound. "Five, four, three, two, one" There's a loud clattering as the sled shoots forward at 22 feet per second and the helmet drops to meet it at 12 feet per second -- crack. (Foster, T., 2013)

I can see on the computer that the head sustained about 170 Gs of linear force, and it rotated 14,100 radians per second squared (the standard scientific metric for rotation). It's a big hit, one that would probably result in a concussion or worse.... (Foster, T., 2013)

Now comes the second helmet. Every variable is the same as in the frst test except for the addition of the low-friction MIPS layer. “Five, four, three, two, one…”—crack. This time the computer shows rotation of 6,400 radians per second squared, a 55 percent reduction. (Foster, T., 2013)

He looks at the colorful graphs on the computer screen again. If the test dummy were a football player, he would have just walked away from a game-ending impact without a concussion... (Foster, T., 2013)

Reference:

Foster, T. (2013, January). The helmet wars. Popular Science, 282(1), 50-77.
     Retrieved from http://web.ebscohost.com/src/pdf?sid=a2e45edc-86e0-422b-9459-74481d7cfe4d%40sessionmgr111&vid=8&hid=112

(The copyright statement on this article permits distribution to a limited list of people, but does not allow publishing to the general public. If you do not subscribe to EBSCO, email me if you would like a link to the read the article.)